HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Turrentine, M. W. Articles by Brown, J. W. Search for Related Content PubMed PubMed Citation Articles by Turrentine, M. W. Articles by Brown, J. W. Related Collections Valve disease

Ann Thorac Surg 2001;71:S356-S360
© 2001 The Society of Thoracic Surgeons

---

Autografts, allografts, and biological valves in children

Biological versus mechanical aortic valve replacement in children

^a Section of Cardiothoracic Surgery, James W. Riley Hospital for Children, and Indiana University School of Medicine, Indianapolis, Indiana, USA

Address reprint requests to Dr Turrentine, Section of Cardiothoracic Surgery, Indiana University School of Medicine, 545 Barnhill Dr, EH 215, Indianapolis, IN 46202-5123
e-mail: mturren{at}iupui.edu

Presented at the VIII International Symposium on Cardiac Bioprostheses, Cancun, Mexico, Nov 3–5, 2000.

Background. Aortic valve replacement in children remains challenging because of constraints imposed by available prosthetic devices. Potential risks of anticoagulation with mechanical valves and degeneration of other biological substitutes have kindled interest in the Ross procedure. This study outlines the evolution of our 27-year experience with prosthetic devices.

Methods. Ninety-nine patients who underwent aortic valve replacement (January 1973 through September 2000) were included in this study. Procedures included implantation of pulmonary autograft (PA) (n = 42), aortic homograft (AH) (n = 3), mechanical valves (MV) (n = 41), and xenograft tissue valves (XG) (n = 13).

Results. The mean follow-up times were: 3.8 ± 1.3 years for PA, 3.5 ± 1.5 years for AH, 7.7 ± 4.7 years for MV, and 8.4 ± 4.8 years for XG. There were no significant differences in perioperative outcomes among the groups (p 0.05) or early deaths (2 each in the MV, AH, and PA groups). The incidence of valve-related complications and reoperations was high in the MV (n = 5), XG (n = 7), and AH (n = 1) groups as compared with the PA group (n = 3, p < 0.01). Early and late mortality for the series was 8.6% (n = 8). Overall, the reoperation rate was 20.7% (n = 18): 15.2% (5 of 33) MV, 70% (7 of 10) XG, 50% (1 of 2) AH, and 11.9% (5 of 42) for PA. The actuarial survival rate was 87.8% and 100% at 10 years for MV and XG, and 95.2% and 6.6% at 7 years for PA and AH.

Conclusions. Aortic valve replacement in children can be performed with acceptable mortality and good long-term results. The Ross procedure, although more complicated, has the advantage of not requiring anticoagulation therapy, can be performed in all age groups, possesses inherent growth potential, and exhibits the most normal left ventricular outflow tract hemodynamics.

This article has been cited by other articles:

				S. K. Pasquali, D. Shera, G. Wernovsky, M. S. Cohen, S. Tabbutt, S. Nicolson, T. L. Spray, and B. S. Marino Midterm outcomes and predictors of reintervention after the Ross procedure in infants, children, and young adults J. Thorac. Cardiovasc. Surg., April 1, 2007; 133(4): 893 - 899. [Abstract] [Full Text] [PDF]

				K. R. Kanter, P. M. Kirshbom, and B. E. Kogon Redo Aortic Valve Replacement in Children Ann. Thorac. Surg., November 1, 2006; 82(5): 1594 - 1597. [Abstract] [Full Text] [PDF]

				M. Doss, J. P. Wood, S. Martens, G. Wimmer-Greinecker, and A. Moritz Do Pulmonary Autografts Provide Better Outcomes Than Mechanical Valves? A Prospective Randomized Trial Ann. Thorac. Surg., December 1, 2005; 80(6): 2194 - 2198. [Abstract] [Full Text] [PDF]

				T. Karamlou, K. Jang, W. G. Williams, C. A. Caldarone, G. Van Arsdell, J. G. Coles, and B. W. McCrindle Outcomes and Associated Risk Factors for Aortic Valve Replacement in 160 Children: A Competing-Risks Analysis Circulation, November 29, 2005; 112(22): 3462 - 3469. [Abstract] [Full Text] [PDF]

				C. Rergkliang, V. Chittithavorn, A. Chetpaophan, and P. Vasinanukorn Surgery for Aortic Insufficiency Associated with Ventricular Septal Defect Asian Cardiovasc Thorac Ann, March 1, 2005; 13(1): 61 - 64. [Abstract] [Full Text] [PDF]

				M. Ruel, A. Kulik, B. K. Lam, F. D. Rubens, P. J. Hendry, R. G. Masters, P. Bedard, and T. G. Mesana Long-term outcomes of valve replacement with modern prostheses in young adults Eur. J. Cardiothorac. Surg., March 1, 2005; 27(3): 425 - 433. [Abstract] [Full Text] [PDF]